| NPI | 1932251600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CARROLL MILLER President 217-224-1744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 036-083011) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |