| NPI | 1861994121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONIA COATES-SMITH Member/Owner 314-482-6928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO LC001567704) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |