| NPI | 1992826309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE HAYMON Owner 314-647-3667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO 000170) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MO 000170) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |