| NPI | 1740507821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANN FETZNER Executive Director 815-337-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180000371) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2010-04-28 |