| NPI | 1306165535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN TACKET Director Of Operations 573-443-2204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |