| NPI | 1538658372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTIN MAYS Provider/Owner/Clinical Director 618-316-3826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2024-05-15 |