| NPI | 1205883428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN RICHARD BURNS Executive Director 217-465-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A-0236-0002-A) |
| 101YM0800X Counselor, Mental Health (Licence: IL 04072) | |
| 251C00000X Day Training, Developmentally Disabled Services (Licence: IL 04072) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-09-17 |