| NPI | 1679966949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBY JOHNSON Behavior Analyst 309-360-6268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |