| NPI | 1639207590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE BUTLER President & CEO 314-367-7848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2014-05-13 |