| NPI | 1063872570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH HARPER Executive Director 618-482-7330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2023-07-12 |