| NPI | 1851074306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORI DE LA CRUZ Licensed Clinical Social Worker 815-621-3497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-08-11 |