| NPI | 1225475262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JO WILSON Executive Director 573-248-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2013-05-31 |