| NPI | 1235825514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISA ANNE ISBELL CEO/Owner/Pa 309-229-8367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2024-09-18 |