| NPI | 1730567751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 660-665-1962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO CC01430115) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2022-07-29 |