| NPI | 1922253947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN BOWLING Director 217-588-2626 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2023-10-31 |