| NPI | 1659023885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH JOHNSTON Owner 815-289-8619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-01-19 |