{
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"FirstLineMailingAddress": "1308 CECELIA ST",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "573-547-7170",
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"PracticeLocationAddressFaxNumber": "573-547-2171",
"EnumerationDate": "03/16/2007",
"LastUpdateDate": "08/22/2020",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "VERNON",
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"Taxonomies": {
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"TaxonomyName": "Intellectual and/or Developmental Disabilities Residential Treatment Facility",
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}
},
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}
}