| NPI | 1588252159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MALONEY Executive Director 815-933-2493 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-01-08 |