| NPI | 1780489823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PARKS Chief Medical Director 573-864-8773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-02-13 |
| Last Update Date | 2025-02-13 |