| NPI | 1023625951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TAYLOR CFO 815-320-7190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |