| NPI | 1437681889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN S LAURITSEN Counselor 309-371-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A23960001A) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |