| NPI | 1386856409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBER L BROWNE Director Of Finance 618-282-6233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 04076) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-02-04 |