| NPI | 1508154584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA LATRISE STEWART CEO/Lcpc 708-481-4257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180007522) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 101YS0200X Counselor School | |
| 251S00000X Community/Behavioral Health (Licence: IL 180.007522) | |
| 252Y00000X Early Intervention Provider Agency (Licence: IL CS10850909P) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2018-02-20 |