NPI | 1407058894 |
---|---|
Entity Type | Organization |
Authorized Contact | VARO DAVIS Administrator 314-862-1662 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 267669513) |
Enumeration Date | 2007-06-05 |
Last Update Date | 2020-08-22 |