| NPI | 1013189117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GERBERDING Office Manager 618-397-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 036046371) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-03-28 |