| NPI | 1992112916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLE WAHOFF Manager 314-434-2769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: MO 1194) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2014-07-22 |