| NPI | 1578864674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDA ANNETTE WORTHON License Professional Counselor 417-881-1249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: MO 1999136664) |
| Enumeration Date | 2010-11-06 |
| Last Update Date | 2011-01-04 |