| NPI | 1194257600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY COOPWOOD Manager 314-420-4360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MO 2426) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |