| NPI | 1427670819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA KITTSTEIN Manager 618-979-7301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |