| NPI | 1467289983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA S HAINES Owner 573-289-8495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2024-09-18 |