| NPI | 1578732103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB TAYLOR CFO 815-320-7190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2021-09-21 |