| NPI | 1215473673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J REEVES Owner/Director 217-210-2476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A-63130001-A) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-01-10 |