NPI | 1154070175 |
---|---|
Other Name | NONE |
Entity Type | Organization |
Authorized Contact | ALEXANDER SHLAFSHTEYN Member 314-504-0404 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
261QM0801X | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2022-03-18 |
Last Update Date | 2022-12-05 |