| NPI | 1457846719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE S PLEASANT Director 217-422-6908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A-5441-0003-A) |
| Additional Taxonomies | 251B00000X Case Management (Licence: IL A-5441-0003-A) |
| 261Q00000X Clinic/Center (Licence: IL A-5441-0003-A) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180-005694) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 180-005694) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 180-005694) | |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |