| NPI | 1679928501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ESSEX Chief Operating Officer 573-803-4145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 3056-7335) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-01-24 |