| NPI | 1609673276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLEY NIGRO Owner 309-989-0511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2025-02-28 |
| Last Update Date | 2025-05-19 |