NPI | 1932706603 |
---|---|
Entity Type | Organization |
Authorized Contact | KAREN ANTOINETTE JOHNSON Co Owner 573-528-6527 |
Organization Subpart ? | No |
Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Additional Taxonomies | 311Z00000X Custodial Care Facility |
Enumeration Date | 2020-10-06 |
Last Update Date | 2020-10-06 |