NPI | 1528125788 |
---|---|
Other Name | CSTAR-ADOL-ROLLA |
Entity Type | Organization |
Authorized Contact | TERESA PORTER Credentialing Manager 660-890-8156 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2007-01-03 |
Last Update Date | 2019-01-24 |