| NPI | 1730527904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA LEWIS Director, Administrator, President 573-201-8654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2017-10-11 |