| NPI | 1427227891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH HARPER Executive Director 618-482-7330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X (Licence: IL 251S00000X) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2023-07-12 |