| NPI | 1679742506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J HARPER Executive Director 618-482-7330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2023-07-12 |