| NPI | 1154888014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN STRONG Director 314-973-9571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2025-07-26 |