| NPI | 1245786698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA LYNN BASSETT Owner 309-831-9558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149013779) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |