| NPI | 1801058953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHAN HENDRIK MOSTERT Director 417-886-3835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |