| NPI | 1336740273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHELLE THOMPSON Owner 314-422-8716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 261QF0050X Clinic/Center Family Planning, Non-Surgical | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2022-03-23 |