NPI | 1053450601 |
---|---|
Entity Type | Organization |
Authorized Contact | TERESSA M. PERDIEU Executive Director 217-348-8108 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-0631-0009-A) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2018-10-22 |