| NPI | 1083034383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA C MILLISCM Assistive Member 620-605-1381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KS In progress) |
| Additional Taxonomies | 251E00000X Home Health (Licence: KS In Progress) |
| 253Z00000X In Home Supportive Care (Licence: KS In Progress) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KS In Progress) | |
| 347C00000X Private Vehicle (Licence: KS In Progress) | |
| 385H00000X Respite Care (Licence: KS In Progress) | |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2014-04-25 |