| NPI | 1225843113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA KIM VILT Senior Vice President And CFO 815-935-7542 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-02-10 |