| NPI | 1881009207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SLATER Office Manager 815-730-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.009965) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |