| NPI | 1790165587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA HOFFSTOT Owner 618-741-8543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2010040541) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |