| NPI | 1477866291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG EDWIN WATERSTREET Counselor 309-833-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-000769) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2023-07-12 |