NPI | 1477112092 |
---|---|
Entity Type | Organization |
Authorized Contact | VICKI SPRAUL President 314-266-2678 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2019-06-07 |
Last Update Date | 2024-04-24 |