| NPI | 1477745677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN ANNE GRINDLER Executive Director 573-875-8556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MO OC1064) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |