| NPI | 1912608274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LAMAR WILSON Partner 314-443-6870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-03-14 |