| NPI | 1427556521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY D PHILLIPS Ar Dept Manager 618-937-6483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2021-03-26 |