NPI | 1013063486 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MO 6300-9238) |
Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: MO 6300-9238) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2022-06-07 |