| NPI | 1174900567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESSA M. PERDIEU Executive Director 217-348-8108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0631-0005-A) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2018-10-22 |