| NPI | 1245072172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JONES Director Of Business Operations/Qua 618-939-4444 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |