| NPI | 1043271190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN R STATZ Executive Director 815-232-8336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IL 001) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-07-21 |