| NPI | 1164235362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OPAL JONES President & CEO 314-535-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-01-30 |