| NPI | 1679615363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN MARTINEZ VP Of Patient Services 815-599-7529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2018-11-05 |