| NPI | 1528504610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE AHLQUIST Owner 630-209-2965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149-009872) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-01-12 |