| NPI | 1699020503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE L HEBERT Director 573-986-4985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |