| NPI | 1083672372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON KERMATH Rcm 217-621-4979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: OH 020249850) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2025-11-10 |