| NPI | 1518549625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN SCHULTE Owner / Single Member LLC 618-567-6269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2021-04-27 |