| NPI | 1891544318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NOSACKA Northwest Region CFO 618-641-5468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0002X Clinic/Center Emergency Care |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-30 |