| NPI | 1053953422 |
|---|---|
| Doing Business As | KIRKWOOD MEDICATION ASSISTED TREATMENTS |
| Entity Type | Organization |
| Authorized Contact | GARY HAMMEN Member 314-644-8310 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2020-05-25 |