| NPI | 1063704989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE BOWEN Chief Financial Officer 217-773-3325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2021-07-06 |