| NPI | 1215053137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUELLEN ADAMS TOMPKINS Owner Administrator 573-998-2506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 5433-9493) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |