| NPI | 1174758452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM STEVENS Operations Manager 618-656-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 060006403) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2009-05-15 |