| NPI | 1548689300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARRIEL DENISE BIVENS Cds Coordinator 314-656-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |