| NPI | 1144713884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE FARLEY Regional Manager 314-750-0966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-03-19 |