| NPI | 1093723959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET VOSS CFO 314-814-8571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MO 5008995962) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2021-09-27 |