| NPI | 1770775934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY JO DYE President 8155-355-3596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 166.000653) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |