| NPI | 1831815190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY GALLON Cred & Enrollment Coord 314-495-6037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-18 |