| NPI | 1144674342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN SANDO CEO 573-888-5925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-29 |