| NPI | 1952768889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN LEE GARNER Director 314-833-4185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |