| NPI | 1306594411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE JOHNSON Director Of Behavioral Health 618-783-4154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-03-17 |