NPI | 1285278432 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANK SAMUEL Co CEO 815-759-7135 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2019-10-31 |
Last Update Date | 2021-02-23 |