NPI | 1568631133 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVE WALTER MINGUS CEO 309-347-5579 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2008-02-27 |
Last Update Date | 2018-07-12 |