| NPI | 1538114608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA K COWSER Financial Director 618-658-3079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 251S00000X Community/Behavioral Health | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-04-14 |