NPI | 1083068191 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: MO 2121) |
Enumeration Date | 2016-04-15 |
Last Update Date | 2022-06-07 |