| NPI | 1942449194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANNEL GENISE THOMAS Director Of Clinical And Outpatient 314-565-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 385H00000X Respite Care (Licence: MO 001305902) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MO 002136058) | |
| 251300000X Local Education Agency (LEA) (Licence: MO SEO200902) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2020-02-05 |