| NPI | 1578910063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE O'BRIEN Business Manager 815-963-0683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2024-06-25 |