| NPI | 1528446630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY WISSEL Administrator 618-263-3873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2024-12-20 |