| NPI | 1447559356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R WHITE President 309-287-9464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IL 149.004861) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |