| NPI | 1811484108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON MILLER Billing Analyst 309-687-7241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IL 2B05-IPI-130) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |