| NPI | 1902973910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY HUELSMANN Executive Director 618-394-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149-007158) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |