| NPI | 1629373600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WILSON CFO 636-866-1341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 235Z00000X Speech-Language Pathologist, | |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2014-04-14 |