| NPI | 1770600355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LACY Office Manager 217-698-7150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-000828) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-04-27 |