| NPI | 1396082277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMONE WEBB Owner 314-839-7790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-01-11 |