| NPI | 1093690398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DELLITT Authorized Official 309-779-2218 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2025-08-07 |
| Last Update Date | 2025-08-07 |