| NPI | 1285713289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN RENEE KLIETHERMES Credentialing Specialist 573-303-7219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 000046739) |
| Additional Taxonomies | 251S00000X (Licence: MO 430681470A) |
| 253J00000X Foster Care Agency (Licence: MO 000046739) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MO 0A) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 000045712) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 000045767) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 0000469461) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 000363075) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: MO 001943115) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-07-21 |