| NPI | 1407989304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 6300-9238) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2022-07-29 |