| NPI | 1649035528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA COOPER Co Owner 309-287-6041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |