| NPI | 1376588871 |
|---|---|
| Doing Business As | BELLEVILLE PEDIATRIC & ADOLESCENT HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | LARRY MCCULLEY CEO 618-332-0694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208000000X Pediatrics |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2014-08-08 |