| NPI | 1639662877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE K. ROGERS Owner/Social Worker 815-715-8757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 149.015580) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |