| NPI | 1942750930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWNILLE LAWRENCE Human Resources Coordinator 618-998-9894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: IL 160.007354) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |