| NPI | 1447641170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ARELLANO Controller 815-723-3405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2020-08-18 |