| NPI | 1760659445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUEY LEE HAWKINS Owner 314-882-6840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2002027247) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |