| NPI | 1518045442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A HUELSKAMP Executive Director 618-526-3905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2015-12-01 |