| NPI | 1538750286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY M GRIFFIS Nurse Practitioner 815-354-7442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2021-01-26 |