| NPI | 1013066059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD NORRIS Executive Director 573-443-6044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 15969603) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |