| NPI | 1083828362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA CORNWELL Clinical Supervisor 316-942-4261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KS 229) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |