| NPI | 1710414271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAHNAHSHA DEAS Owner/Manager 314-800-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MO 2011350180) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2021-11-08 |