| NPI | 1154365823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE D. O'BRIEN Director Of Finance 815-963-0683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IL 0413) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-04-15 |