NPI | 1164553475 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
Organization Subpart ? | No |
Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MO 6300-9238) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO 6300-9238) |
Enumeration Date | 2007-03-08 |
Last Update Date | 2022-06-10 |