| NPI | 1992846802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY TROESSER Accountant 573-634-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |