| NPI | 1396260683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEAORL PARKS Owner 815-603-4310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: 180008970) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: IL 180008970) | |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2024-02-23 |