| NPI | 1730992306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE LAMONTE BURGESS Network Director 314-745-3541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2025-01-28 |
| Last Update Date | 2025-01-28 |