| NPI | 1063918811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERESE M ALCORN Licensed Clinical Social Worker 314-556-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2021-03-31 |