| NPI | 1346025285 |
|---|---|
| Doing Business As | FOREVERMORE HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | DEMITRIUS BRACKETT Mental Health Provider 815-766-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| 174200000X Meals | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR1100X Clinic/Center, Research | |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2025-12-03 |