| NPI | 1750160651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMARYEE CARTEZ DAMPIER Owner 573-239-1131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-10-10 |