| NPI | 1104568872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA POHLMAN CEO 217-248-8512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |