| NPI | 1285476622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA L SPICER Owner 217-930-2106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-06-07 |