| NPI | 1689313082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOTOLA WASILAT DANMOLE-ODIMAYO Admistrator 217-553-0266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2025-10-24 |