| NPI | 1841698594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENS HUSSEY Owner 708-308-4149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30569 CADC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.008539) |
| 101YP2500X Counselor, Professional (Licence: IL 178.007150) | |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |