| NPI | 1144549494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KENNEDY President/CEO 309-671-8005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X (Licence: IL A0324-0007-A) |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-0324-0007A) | |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: PS0144648) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2017-12-14 |