| NPI | 1477919587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA NISSENBOIM Owner 314-477-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MO 730) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |