| NPI | 1518535285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WOOD Owner 573-576-3029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-06-17 |