NPI | 1457841660 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER ANN TABOR Owner 815-331-8768 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2018-05-14 |
Last Update Date | 2018-05-14 |