| NPI | 1902053655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA LEWIS Executive Director 815-455-2828 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-08-25 |