| NPI | 1629427042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARA PENNINGTON Executive Director 314-531-0511 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 00) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2022-07-21 |