| NPI | 1972477644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA LATEIKE WILLIAMS CEO 314-933-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 251V00000X Voluntary or Charitable | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 261Q00000X Clinic/Center | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| 261QP2300X Clinic/Center, Primary Care | |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2025-10-03 |
| Last Update Date | 2025-10-03 |