| NPI | 1871908285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDONNA HALL Therapist 217-621-5583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.008352) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |