| NPI | 1427456037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON J. LIST President 224-217-2435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 060011386) |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2014-12-12 |