| NPI | 1063785442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA WOOFTER Program Manager 573-514-7312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2024-01-05 |