| NPI | 1134879224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA K COWSER Financial Director 618-652-2046 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2022-03-24 |