| NPI | 1083091458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-7895-0002-A) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2022-06-10 |