| NPI | 1770399305 |
|---|---|
| Doing Business As | HAELAN |
| Entity Type | Organization |
| Authorized Contact | CONNIE MARIE THOMAS Owner/Nurse Practitioner 618-554-8730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-09 |