| NPI | 1699173542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN HALL-DAVIS President 618-622-9240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036080270) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2014-12-09 |