| NPI | 1932598877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PICO Owner 217-840-6992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |