| NPI | 1417123480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERCY MENZIES President 314-645-6840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 588110349) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |