| NPI | 1831544436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY HUELSMANN Chief Executive Officer 618-213-8705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |