| NPI | 1073364758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN SANCHEZ Manager Of Business Operations 309-382-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2024-03-29 |