| NPI | 1285073411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE LYNN LANGLEY Member 573-378-2462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2015-08-11 |