| NPI | 1689811945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARISSA ANNE TRACY Executive Director 573-339-9552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2018-12-04 |