| NPI | 1043988512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2024-01-29 |