| NPI | 1497828735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHUCK MESECK Executive Director 1414-536-8333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2211125) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |