| NPI | 1659035350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM DUANE BIZELLI Owner/Clinical Supervisor 636-345-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2021-10-28 |