| NPI | 1588794317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL RANEY CEO 217-693-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A-0606-0001-A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A-0606-0004-A) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A-0606-0007-A) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0606-0001-A) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0606-0007-A) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-0606-0002-A) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0606-0004-A) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-07-21 |