| NPI | 1033476676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN STEVEN MILLER Owner 314-382-9318 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2008008117) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |