| NPI | 1932546702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER D CRABTREE Owner 417-616-3180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MO 2012013743) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2015-09-23 |