| NPI | 1164635322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SIMON LONDE Director 417-781-2868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 1175) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |