| NPI | 1164553566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS J MILLIMAN President & CEO 800-428-7260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A01600006A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A01600006A) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2013-08-16 |