| NPI | 1447024435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINNA HOUSE Division Director 815-221-6021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2023-11-09 |