| NPI | 1124870183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN E GINSKI President 815-683-8700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2024-04-03 |