| NPI | 1083219240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE BOWEN Director Of Billing 217-773-3325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2020-12-03 |