| NPI | 1972533990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN BOEHMER C.E.O. 618-242-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2022-05-09 |