| NPI | 1679925333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL WAGNER-CANTINE Owner 309-825-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 180.008394) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 180.008394) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |