| NPI | 1356630743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH SORENSON Office Manager 618-692-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL 180.004715) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2011-04-06 |