NPI | 1083104558 |
---|---|
Entity Type | Organization |
Authorized Contact | RACHEL SHEETS Managed Care Contracting Assistant 815-387-5680 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2018-05-10 |
Last Update Date | 2019-01-04 |