| NPI | 1972001386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBY BARNETT CFO 573-632-2777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 122300000X Dentist | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2023-10-27 |