| NPI | 1235308602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY ELAINE STUCKEY Owner/Administator 660-826-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MO 035165) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2008-02-29 |