| NPI | 1528853033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TURQUOIS WHITE Clinical Therapist 618-316-9143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-04-14 |