| NPI | 1760931828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA A GOOD VP/CFO 815-284-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2018-01-09 |