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 |