| NPI | 1235261058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M. CREWS Executive Director 573-581-8210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2025-09-11 |