| NPI | 1336393669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM LYONS Lpc 417-833-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MO 2008032814) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MO 2008032814) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-11-13 |