| NPI | 1053827964 |
|---|---|
| Doing Business As | DIANA'S BOARDING HOME #3 |
| Entity Type | Organization |
| Authorized Contact | DIANA FAYE COOK Owner/President 573-238-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2017-12-15 |