| NPI | 1245363183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 660-665-1962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MO 6300-9238) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2022-07-29 |