| NPI | 1952880254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER WILHELM Director Of Client Accounts 636-779-1444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2023-10-10 |