| NPI | 1154971984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE HAMPTON CEO 618-273-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-09-13 |