| NPI | 1699153213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA L WALKER CEO/Founder 618-207-3479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL A4215-0001-A) |
| Additional Taxonomies | 251B00000X Case Management (Licence: IL A4215-0001-A) |
| 252Y00000X Early Intervention Provider Agency (Licence: IL A4215-0001-A) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2016-03-29 |