| NPI | 1104262385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 1199) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2022-06-10 |