| NPI | 1366744054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK SAMUEL Co CEO 815-759-7135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2022-08-17 |