NPI | 1184412827 |
---|---|
Entity Type | Organization |
Authorized Contact | KAITLYN CORNELL CEO 217-621-0766 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2025-04-30 |
Last Update Date | 2025-04-30 |