| NPI | 1871829598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY HERATY Owner 815-823-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 02023326) |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2009-10-30 |