| NPI | 1164657664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA LOUISE SMITH Administrator/Executive Director 660-726-3035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: MO 2001029548) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-05-27 |