| NPI | 1760855431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE LYNN GOODMAN Program Director 417-544-0630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care (Licence: MO 1291) |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2021-04-15 |