| NPI | 1629247366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE WALTER MINGUS CEO 309-347-5579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2018-07-12 |