| NPI | 1619139227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN R TINSLEY Owner 573-686-4209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2014-01-28 |