| NPI | 1043692775 |
|---|---|
| Doing Business As | FW4C |
| Entity Type | Organization |
| Authorized Contact | ALEISHA J FRAZIER Director 816-922-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101Y00000X Counselor |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |