NPI | 1154708923 |
---|---|
Entity Type | Organization |
Authorized Contact | GAIL RANEY CEO 217-693-3021 |
Organization Subpart ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A06060007A) |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0606-0007-A) |
Enumeration Date | 2015-04-30 |
Last Update Date | 2022-07-21 |