| NPI | 1558659466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY MCCULLEY Member 573-866-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MO 039146) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2011-07-12 |