| NPI | 1962658195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON QUANDT Executive Director 217-347-7179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2018-11-29 |