| NPI | 1871626440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JO WILSON Executive Director 573-248-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2013-05-29 |