| NPI | 1508675984 |
|---|---|
| Doing Business As | KENYON DOUGLASS |
| Entity Type | Organization |
| Authorized Contact | KENYON R DOUGLASS Owner/Operator CEO 312-388-9182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103K00000X Behavior Analyst | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| Enumeration Date | 2024-12-31 |
| Last Update Date | 2024-12-31 |