| NPI | 1548534688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DEAN Director Of Business Services 217-223-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |