| NPI | 1164603072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEDDY EUGENE RUTH CEO 573-368-4899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2007-11-19 |