| NPI | 1790908200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM NELSON CEO 309-344-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness (Licence: IL 029) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-07-21 |