| NPI | 1568914927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY LYNN THOENEN Counselor 573-619-8919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MO 2016035718) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-11-01 |