| NPI | 1316991896 |
|---|---|
| Doing Business As | ST. LOUIS DEVELOPMENTAL DISABILITIES TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | MOLLY JANE BOECKMANN Director Of Administrative Services 573-751-4055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208000000X Pediatrics |
| 208800000X Urology | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-10-20 |