| NPI | 1619330404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB TAYLOR CFO 815-320-7190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-05-20 |