| NPI | 1770195315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON WADE MOORE Partner/Certified Peer Specialist 636-344-6572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |