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 (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 |