| NPI | 1790072262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE NICOLE DOCKINS Case Manager 314-308-2508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |