| NPI | 1649037987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL L MITCHELL-LOCKWOOD Licensed Counselor 815-370-5212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |