NPI | 1194382069 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSE BELLE Owner 815-708-5919 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2019-05-24 |
Last Update Date | 2019-05-24 |