| NPI | 1417313057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNA WEBB Director 618-988-8178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: IL 200500002m) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 200500002m) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |