| NPI | 1992772149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA ZUMBAHLEN Administrator 618-783-4436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: IL 261qh0100x) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2023-05-16 |