| NPI | 1952022527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY GONZALEZ Owner 618-468-8069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2023-06-04 |