NPI | 1578868808 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL T. BURNS President 815-455-0044 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 071004478) |
Enumeration Date | 2011-01-18 |
Last Update Date | 2011-01-18 |