| NPI | 1629402698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY JEAN GORENZ Vice President 815-876-6285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180001089) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 4271) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149002582) | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |