| NPI | 1588391833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MITROKA President/CEO 618-724-2401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2022-08-05 |