| NPI | 1508041906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD R. BAER President 815-477-7481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A- 2019-0001-A) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-01-03 |