| NPI | 1598912263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA K COWSER Financial Director 618-652-2046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2021-11-18 |