| NPI | 1639295314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA CARNEY CEO 618-956-9521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 122300000X Dentist | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 133V00000X Dietitian, Registered | |
| 207Q00000X Family Medicine | |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-04-05 |