| NPI | 1710420955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN DEE SENOFF Clinical Social Worker 217-359-4066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149002453) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |