| NPI | 1730203563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEOTA FAYE DICKEN Owner 573-785-0482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2025-09-11 |