| NPI | 1558788679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ALLEN SMITH Owner 309-363-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 69365) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-29 |