| 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 | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2024-01-12 |