| NPI | 1407723810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A CALLOWAY Owner 314-252-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |