| NPI | 1639063258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY L DENNING Owner 417-392-7307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2025-06-06 |
| Last Update Date | 2025-06-06 |