| NPI | 1417526377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RENEE CLABON CEO 314-367-5820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2021-06-24 |