| NPI | 1568541886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GALE LACY Office Manager 573-335-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: MO 031626) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MO 031626) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |