| NPI | 1811029689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYA SUE BORKE Owner 660-826-6439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 320900000X) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |