| NPI | 1922474279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIFFIN MULCAHEY COO & General Counsel 217-369-3293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2016-04-05 |