NPI | 1629426002 |
---|---|
Entity Type | Organization |
Authorized Contact | PHIL EATON CEO / President 815-391-1000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
Enumeration Date | 2016-05-26 |
Last Update Date | 2019-07-02 |