| NPI | 1639418676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN WILLARD Executive Director 309-451-9495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 198405) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2016-11-22 |