| NPI | 1013591338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETOYA WHITE Owner 314-390-8107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-05-12 |