| NPI | 1982182671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL SHEETS Managed Care Contracting Assistant 815-387-5680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2018-08-03 |