| 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 |