| NPI | 1518209535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL LYNN KEATON Manager 217-354-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149.014129) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2013-03-18 |