| NPI | 1942056908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL J RANDALL Clinical Director 630-740-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |