| NPI | 1407986847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ANTIONO MILLER Administrator 314-772-5107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: MO 589) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |