| NPI | 1952612335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL QUINN Owner 630-408-8108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180006854) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 27416) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |