| NPI | 1679771430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW MAINE Director Of Information Technology 417-376-2238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2022-10-26 |