| NPI | 1093427551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY GOODRICH MITTS Licensed Clinical Psychologist 217-666-7044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2022-12-15 |