| NPI | 1174231484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRESTON KING Director 573-429-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| 104100000X Social Worker | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2026-03-05 |