| NPI | 1699356113 |
|---|---|
| Doing Business As | DBA MISSOURI MENTOR |
| Entity Type | Organization |
| Authorized Contact | RACHEL KRAMER Executive Director 660-815-4997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-16 |