| NPI | 1427115468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRA LYNN CALLAHAN CEO 573-888-5925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 1285-10223) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-04-28 |