| NPI | 1790063576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA GOOD VP/CFO 815-284-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2021-07-01 |