| NPI | 1154704187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 660-665-1962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MO CC01430115) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2022-06-10 |