| NPI | 1295107563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL DAWN JONES Owner 618-581-3751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 178.011045) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2015-10-27 |