| NPI | 1871984500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ARELLANO Controler 815-723-3405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2020-08-03 |