NPI | 1912291816 |
---|---|
Entity Type | Organization |
Authorized Contact | REBECCA ANN RENGO KOCHER Owner 636-300-3948 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO SW000377) |
Enumeration Date | 2011-06-08 |
Last Update Date | 2011-06-08 |