| NPI | 1306690565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE O'BRIEN Director Of Finance 815-963-0683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-16 |