NPI | 1942719885 |
---|---|
Entity Type | Organization |
Authorized Contact | CATHY LUEBBERING Owner 314-202-1415 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO 2005018314) |
Enumeration Date | 2017-09-22 |
Last Update Date | 2022-07-21 |