| NPI | 1477147478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY GLENN Chief Clinical Officer 314-392-3822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-02-22 |