| NPI | 1912688987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CRUMBLE COO 618-691-8352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 405300000X Prevention Professional | |
| 171M00000X Case Manager/Care Coordinator | |
| 171W00000X Contractor | |
| 172V00000X Community Health Worker | |
| 174H00000X Health Educator | |
| 251S00000X | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-08-30 |