| NPI | 1629700422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM BALDWIN Clinical Psychologist 309-204-6614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2022-09-14 |