| NPI | 1134506041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KENNEDY President/CEO 309-671-8005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0324-0006-A) |
| Additional Taxonomies | 251S00000X (Licence: IL 003240006) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2017-12-12 |