| NPI | 1205295102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY RAY MAUPIN Executive Director 217-422-6361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: IL 201200009S) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: IL 201200009S) |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2016-02-19 |