| NPI | 1295990208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY ANN LEE Administrator 573-310-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2008-07-20 |
| Last Update Date | 2008-07-20 |