| NPI | 1962099150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENISE POPE Patinet Accounts Manager 618-332-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2021-01-19 |