| NPI | 1902462278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY L. GLENN Clinical Director 314-392-3822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-06-27 |