| NPI | 1013188945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD HESSMAN Licensed Clinical Professional Coun 620-663-4802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: KS 302F00000X) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |