| NPI | 1801750310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH DORANTES DE INZUNZA Practice Owner 815-219-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-12-10 |
| Last Update Date | 2025-12-10 |