| NPI | 1790942761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BURNS Executive Director 217-465-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL A-0236-0002-A) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2021-09-17 |