| NPI | 1659002210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEENA MAITLAND Director. Credentialing 417-347-7670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-23 |