| NPI | 1528317740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E BERRY President 314-518-8476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MO 21505578) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |