| NPI | 1982044889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN R STOUFFER Principal 217-415-1739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 248000699) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-06-25 |