| NPI | 1609218593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA REDMOND Senior Program Director 314-352-5087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MO EL1-0043-0313) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2013-08-26 |