| NPI | 1942700471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE JOHNSON Director Of Behavioral Health 618-783-4154 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2022-03-03 |