| NPI | 1174822167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA CHRISTINA BRANSON Assistant Clinical Director 573-651-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2022-07-21 |