| 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 |