| NPI | 1619047297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R POLCASTER President Clinical Director 708-448-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 060008046) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2014-03-11 |