| NPI | 1235585431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY PHILLIPS Director Of Revenue Cycles 618-937-6483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2025-07-14 |