| NPI | 1043414022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERYE J. JACKSON CFO 785-841-4138 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: KS 00590942) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-05-29 |