| NPI | 1871047209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLIN LIVINGSTON President / C.E.O. 217-367-3728 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2021-06-08 |