| NPI | 1386034718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELESTE R DAIBER Lpc 314-267-4327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2007008532) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |