| NPI | 1790066082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP EATON CEO / President 815-391-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 04081) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2018-04-27 |