| NPI | 1710225644 |
|---|---|
| Former Legal Business Name | CREATIVE ALTERNATIVES FOR PSYCHOLOGICAL GROWTH LLC |
| Entity Type | Organization |
| Authorized Contact | KELLY VINEHOUT Clinical Director 815-245-6669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071006683) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2015-08-31 |