| NPI | 1619144870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL W DOUGLAS Vice President And CFO 815-935-7256 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: IL 0002014) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL 0002014) |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: IL 0002014) | |
| 282N00000X General Acute Care Hospital (Licence: IL 0002014) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: IL 0002014) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2016-07-28 |