| NPI | 1164813671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BOVEE Owner 309-445-0394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |