| NPI | 1629218862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANI JEAN POELKER Owner 314-210-8424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2004000868) |
| Enumeration Date | 2009-02-28 |
| Last Update Date | 2009-02-28 |