| NPI | 1558587824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY S. BRANNING VP Of Marketing/Fund Development 815-966-1285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0559-0005--A) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-0559-0005-A) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2021-07-29 |