| NPI | 1831831098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE BOWEN Director Of Billing 217-773-3325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-04-08 |