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 |