| NPI | 1043580194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH THOMAS HARTLEY CEO 816-838-1808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 120123210218441) |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-05-14 |