| NPI | 1639581937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBIE SMITH Executive Director 618-876-2383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 251B00000X Case Management | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2021-11-18 |