| NPI | 1386495349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE DAVIS Owner 314-252-8434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-28 |