| NPI | 1477288025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI WADE Administrator 314-680-9480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-07-19 |