| NPI | 1265819635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-7895-0001-A) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2022-07-29 |