| NPI | 1528466430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE A BRODLAND Lcsw 217-744-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149-002608) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2014-12-09 |