| NPI | 1417154568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER K. MODEST Director/CEO 217-442-9026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A55890002A) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2015-09-25 |