| NPI | 1538526488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN M SELANDER Clinical Director 815-520-6972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149017603) |
| Enumeration Date | 2016-01-23 |
| Last Update Date | 2016-01-23 |