| NPI | 1548727209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA WALLACE Vice President Finance 636-359-4890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2025-05-13 |