| NPI | 1972431849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MAHINGA LUTHER Director 573-355-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2026-05-11 |
| Last Update Date | 2026-05-11 |