| NPI | 1013289446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP W EATON President / CEO 815-391-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2013-05-21 |