| NPI | 1548927171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA K COWSER Financial Director 618-652-2046 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2021-11-18 |