| NPI | 1134604093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN ANN WOLFF Participant Coordinator 314-427-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |