| NPI | 1366693632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE PRYDE Interim Adminitrator 217-531-5369 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: IL 251k00000x) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |