| NPI | 1891563789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE WIEMELT Licensed Clinical Social Worker 217-653-8520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2023-12-19 |