| NPI | 1700600137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EVANS Owner 217-223-0170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2025-11-20 |