| NPI | 1225673528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN AKINS Administrator/Owner 314-652-8908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 174200000X |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2019-11-10 |
| Last Update Date | 2019-11-10 |