| NPI | 1992551691 |
|---|---|
| Doing Business As | MADELINE C DOUGLAS |
| Entity Type | Organization |
| Authorized Contact | MADELINE C DOUGLAS Owner 217-607-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |