| NPI | 1932271475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAE NMN PETERS Manager 314-721-1289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MO 031868) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |