| NPI | 1922145499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JOHNS Manager 815-919-0595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 560041AP) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-10-09 |