| NPI | 1063181600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY TIFFENBACK Director Support Services 309-779-3049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-11-17 |