| NPI | 1518091354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGIA I. EYE CEO 573-438-3736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 1799-330) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: MO 1799-330) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |