| NPI | 1447641170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ARELLANO Director Of Finance 815-723-3405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2025-03-14 |