| NPI | 1548067556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN RENEE TAYLOR Clinical Director 573-540-7223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2025-02-26 |