| NPI | 1639350309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARIE BRINKLEY Administrator 573-289-2171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2007-11-21 |