NPI | 1588073753 |
---|---|
Entity Type | Organization |
Authorized Contact | JEREMY GWINN Manager 618-235-0126 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: IL ADS1008005) |
Enumeration Date | 2014-08-12 |
Last Update Date | 2014-08-12 |