| NPI | 1740533900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SIEBERT Director Of Compliance 309-687-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 2B05-IPI-130) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2023-12-18 |