| NPI | 1831625771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA L WILLIAMS Owner/Cds Coordinator 573-380-0685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MO 6448) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-08-20 |