| NPI | 1114140621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM NELSON CEO 309-344-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 020) |
| 101YM0800X Counselor Mental Health (Licence: IL 3709841785020) | |
| 1041C0700X Social Worker Clinical (Licence: IL 020) | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-07-21 |