| NPI | 1083128474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN WILLARD Founder, Former Exec Dir 309-451-9495 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IL 198405) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2017-11-22 |