| NPI | 1750682043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA CAROL MILLER Program Director 314-621-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 8043) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2010-11-03 |