| NPI | 1740632546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT GEORGE CEO 309-687-7218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 004259-13) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-11 |