| NPI | 1740474600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE LYNN SPOTILA Owner 573-378-2462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |