| NPI | 1962210104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUNTA LOVE Licensed Professional Counselor 217-304-6523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2024-12-19 |