| NPI | 1245786631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MESHELL SHARANE WILSON Owner/Director 314-761-4805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-29 |