| NPI | 1932990884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA D HIGGS Member 573-714-1897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2026-04-21 |