| NPI | 1194468298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZINA JACKSON Owner/Founder 636-229-1290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-04-16 |
| Last Update Date | 2022-04-16 |