| NPI | 1114373396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY PHILLIPS Director Of Revenue Cycles 618-937-6483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 251B00000X Case Management |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2025-07-14 |