| NPI | 1992163844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KELLER Counselor 217-607-9256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149.018211) |
| Enumeration Date | 2016-02-07 |
| Last Update Date | 2016-02-07 |