| NPI | 1629485156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE SCHWARTZ Member / Speech Pathologist 573-680-4913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2016-10-26 |