| NPI | 1124798970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER REA HANSEN THOMAS Executive Director 309-532-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2021-09-14 |