| NPI | 1821897992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY ROBERT HIGGINBOTHAM Owner 417-850-3063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-03-11 |