| NPI | 1679618052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE A. DOSCH Administrator 417-882-4485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |