| NPI | 1942870928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE O'BRIEN Director Of Finance 815-963-0683 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2024-06-25 |