| NPI | 1235744533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JAMES MAHANNAH Treasurer 309-827-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-13 |
| Last Update Date | 2020-09-13 |