| NPI | 1376543520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON QUANDT Executive Director 217-347-7179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 04068) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2018-11-29 |