NPI | 1508196494 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY GARRISON CEO 217-362-6262 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A-0200-002-A) |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-0200-002-A) |
324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-0200-001-A) | |
Enumeration Date | 2009-12-28 |
Last Update Date | 2025-05-29 |