| NPI | 1922720770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JEDIDIAH EHLERS Counselor/Professional 224-577-8840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2022-09-16 |