| NPI | 1508810276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE FRANKLIN JENKINS Administrator 573-369-2359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: MO 17551579) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2009-06-26 |