| NPI | 1356625966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J TRAVIS DOWELL Vice President Mps And Operations 217-788-3342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2011-09-30 |