| NPI | 1790802916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAIREL L. DENTON Pres. 573-686-3053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MO N00027062) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |