| NPI | 1790887198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA S MCCUTCHEN Director Of Bmcl 618-993-4117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 149-004386) |
| Additional Taxonomies | 282NR1301X General Acute Care Hospital, Rural (Licence: IL 149-004386) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2020-08-22 |