| NPI | 1588784912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY BLOCK VP Finance 815-223-0160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2024-11-11 |