| NPI | 1851593461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE CECELIA HENDERSON Assistant Administrator 314-383-4863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MO 392) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-04-01 |