| NPI | 1487032769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY EPPERSON Director 217-345-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-6036-0004-A) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2020-07-30 |