| NPI | 1083330443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SMITH Lcpc/Owner 618-505-0784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2023-05-10 |