NPI | 1568607018 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID W. RENNARD President 708-769-1509 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149009614) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 180006436) |
Enumeration Date | 2008-12-12 |
Last Update Date | 2022-09-08 |