| NPI | 1992094601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO 6300-11443) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2022-08-01 |