| NPI | 1831248517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA L MASHBURN Owner 417-326-6512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 14209362) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |