| NPI | 1598898447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA HANSON SUE Billing Supervisor 314-531-0511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |