| NPI | 1104470939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALLAN HOWTON Owner, CEO 314-930-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |