Ebony Wilson is a community based residential treatment facility, intellectual and/or developmental disabilities in Saint Louis, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. Ebony Wilson NPI is 1013334622. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
3514 BLAIR AVE
SAINT LOUIS, MO
ZIP 63107-717
Phone: (314) 216-0088
The enumeration date for this NPI number is 3/20/2014 and was last updated on 3/20/2014.