| NPI | 1376763292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE LEE TUCKER Preisdent 573-431-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |