| NPI | 1184870859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY DARLENE PALM Owner 417-869-1074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2004005777) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |