| NPI | 1619100831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELE M. BRYANT Sole Proprietor 815-726-2546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180000741) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2009-09-04 |