| NPI | 1467334151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY THOMAS Director 314-210-4688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-23 |