| NPI | 1568029635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASITY JENSEN Clinical Social Worker 309-635-8476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2021-09-21 |