| NPI | 1679281026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA LYNN LONGSTREET Program Coordinator 417-538-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |