| NPI | 1134355092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK M. PHELAN Vice President Of Operations 309-687-7255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |