| NPI | 1568594380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY LEE WINICK Executive Program Director 573-756-2899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO 3607295) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |