| NPI | 1033358585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RIBASTE Dc 913-948-6602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: KS 01-04796) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |