| NPI | 1700037876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA STANDIFER CEO 217-766-0492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |