| NPI | 1437424116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY BLOCK VP Finance 815-224-5001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IL 04107) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-04-06 |