| NPI | 1346693223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE JOHNSON Director Of Behavioral Health 618-783-4154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: IL A01400001A) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A01400001A) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-12-07 |