| NPI | 1730337114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRA EVON ROBERTS Administrator 314-839-9157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 2006031224) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |