| NPI | 1942767462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BARBOUR Director Of Patient Accounts 314-471-5350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2020-06-17 |