| NPI | 1083878839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFAYE JACKSON Therapist 573-265-3251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MO 2008015070) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |