| NPI | 1518134840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M RUNDQUIST Counselor 314-724-5849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 135) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |