| NPI | 1174809065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI ALLEN Owner 314-602-9207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO LC1177742) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |