| NPI | 1487120143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY S. BRANNING VP Of Marketing/Fund Development 815-966-1285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |