| NPI | 1770759771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENAY M REYNOLDS Executive Director 618-531-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |