| NPI | 1548615024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESS MARIE GENEL Billing Specialist 417-476-1034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |