| NPI | 1063773935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA L. COLLINS Director, Ccp 618-462-1391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: IL 2046967) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: MO 0012622) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2013-08-08 |