NPI | 1578940557 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL KENNEDY President/CEO 309-671-8005 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0324-0005-A) |
Additional Taxonomies | 251S00000X (Licence: IL 003240005) |
Enumeration Date | 2015-04-29 |
Last Update Date | 2017-12-12 |