| NPI | 1922128487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE SUE CONRAD Owner 573-875-6751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MO 8001661) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2008-06-13 |