| NPI | 1194977264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA J ALLSUP Director Clinical Services 309-676-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A13320001A) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |