NPI | 1447080205 |
---|---|
Doing Business As | BENTON MENTAL HEALTH WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | KIMBERLY MITROKA President/CEO 618-724-2401 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2024-08-06 |
Last Update Date | 2024-08-06 |