| NPI | 1871831339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ANTONIO MILLER Administrator 314-772-5107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MO 1076) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |