NPI | 1760702435 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANNON QUANDT Executive Director 217-347-7179 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 04068) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IL 91S064) |
Enumeration Date | 2010-06-04 |
Last Update Date | 2018-11-29 |