NPI | 1144644097 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTAL LYNN PERRY GUTIERREZ CEO 217-685-1639 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180005489) |
Enumeration Date | 2014-02-13 |
Last Update Date | 2014-02-13 |