| NPI | 1982175212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA TOMARA LYNN Owner 309-532-1293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |