NPI | 1831719913 |
---|---|
Entity Type | Organization |
Authorized Contact | BENJAMIN STORTZ CEO 815-741-7042 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-04-20 |
Last Update Date | 2020-04-20 |