| NPI | 1346524899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM NELSON CEO 309-344-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X (Licence: IL 04016) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2022-07-25 |