| NPI | 1225502057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM WEST CFO 217-877-4694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-04-29 |