| NPI | 1255767166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEESHA WOOD-SMITH Regional Director 217-342-4150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311500000X Alzheimer Center (Dementia Center) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |