| NPI | 1841652443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDSEY JOHNSEN Licensed Clinical Social Worker 815-579-8350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 149016349) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-04-17 |