NPI | 1699803965 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANNA SMITH Owner 417-626-2600 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 1504-9053) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2020-08-22 |