| NPI | 1740169655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLYN CORNELL CEO 217-621-0766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-08-27 |