| NPI | 1588032460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL A NELSON CEO 309-344-4200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A-0118-0010-A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2019-08-19 |