| NPI | 1104540301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN NOEL EARHART CEO 815-520-4926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2022-09-30 |