| NPI | 1851554224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON FUNDELL MINDOCK Director 309-696-4697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180004578) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-07 |