| NPI | 1952042814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES F SPINNER Sr. Director Health Ctr. Compliance 618-332-0953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |