| NPI | 1295128841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MARIE ZYWIEC Owner 309-706-6445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180004875) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-03-06 |