| NPI | 1518208719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES AARON SHULTZ Recovery Specialist 1 618-877-4420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2013-03-13 |