| NPI | 1831274943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN SUSAN PARK Managing Member 314-991-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO LC0731335) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MO LC0731335) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-01-17 |