| NPI | 1932915774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE GARLAND CFO 815-223-0160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-12-06 |
| Last Update Date | 2024-12-06 |