| NPI | 1003241779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY L KRUGER Owner 785-806-6739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KS 200679800a) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |