| NPI | 1326647165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHURCH VP Of Finance And Operations 314-925-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |