| NPI | 1023497237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRICK LEE KILEY President/Director 217-274-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A-3599-0001-A) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |