| NPI | 1881055812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRTLE E RIGEL Owner/Administrator 417-867-3397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO CC03100514) |
| Additional Taxonomies | 385H00000X Respite Care (Licence: MO cc03100514) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-03-22 |