| NPI | 1609086875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MCCORMICK Business Manager 618-732-8242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2015-08-03 |