| NPI | 1023357647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY KLEINLEIN Executive Director 314-205-0588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |