| NPI | 1639298706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY J. ENGHOLM Executive Director 309-792-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: IL A-0625-0004-A) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2017-07-17 |