| NPI | 1891910709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARY GREEN Executive Director 618-877-4987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A06870001A) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |