| NPI | 1447671250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA LUNA Owner 660-491-5667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2011015152) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |