| NPI | 1760114698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN ROCHON Owner 815-529-5933 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2024-02-19 |