| NPI | 1568294130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY D PHILLIPS Revenue Cycle Director 618-937-6483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-14 |