| NPI | 1649474206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 6300-9238) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MO 6300-11443) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-03-09 |