| NPI | 1851975072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE A GARREN Owner 217-318-1076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2024-03-16 |