| NPI | 1053456160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MO 6300-9238) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2022-06-07 |