| NPI | 1861901043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP W. EATON CEO 815-387-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IL A-0601-0052-A) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2018-04-24 |