| NPI | 1063764587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIA ANGELICA ROTH President 314-227-0124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2009030440) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |