| NPI | 1215160049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL LEITZ D LEITZ Executive Director 217-935-9496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |