| NPI | 1871984062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S LONDE Owner 417-781-2868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 1175) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |