| NPI | 1548030596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN E GROVE Licensed Clinical Social Worker 815-973-8160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-01-02 |
| Last Update Date | 2024-01-02 |