| NPI | 1639462948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN C RADZOM Owner 618-248-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149012706) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2016-10-24 |