| NPI | 1649767625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN NEWLAN Owner 417-455-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X |
| 251K00000X Public Health or Welfare | |
| 251V00000X Voluntary or Charitable | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |