| NPI | 1770973067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL HOLOCKER Office Manager 309-347-8282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-1028-0006) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-06-16 |