| NPI | 1386939197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERI S RACKLEY Co Owner/Administrator 417-270-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |