| NPI | 1104450337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY L. GLENN Chief Clinical Officer 314-392-3822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2022-04-05 |