| NPI | 1477171528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY WOLD CEO 314-518-7967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QM0801X | |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2022-01-25 |