| NPI | 1346372166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M. CREWS Executive Director 573-581-8210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |