| NPI | 1497968093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBER L BROWNE Director Of Finance 618-282-6233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0280-0002-A) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-02-04 |