| NPI | 1427426055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE HAEGE Executive Director 618-233-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 199100130S) |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-10-06 |