| NPI | 1912053950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE A HAAS President, CEO 815-939-3543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-09-15 |