| NPI | 1447422936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA A HALLSTROM Owner 815-235-2353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149010827) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |