| NPI | 1124145347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMARA GAINES Administrator 573-886-2191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 1982-8946) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2008-07-01 |