| NPI | 1598048571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LAVERNE COOK Lpc 573-358-4393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MO 2000154534) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2011-09-26 |