| NPI | 1740636067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WILSON Executive Director 573-248-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MO 1517) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |