| NPI | 1942700083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ADELMAN CFO 815-901-6866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2021-02-23 |