| NPI | 1972900918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANETTA BOLDEN-ROBERTS Business Manager 314-413-3862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 1215) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |