| NPI | 1710664867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BERTEL Owner 314-200-5548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2025-01-09 |