| NPI | 1639503691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELDRIGE DALE WORLEY Administrator 573-614-4318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MO 002422631) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |