| NPI | 1750616199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L CASEY Administrator 636-526-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO pending) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-10-02 |