| NPI | 1093349813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY LAKIN Medical Director/Authorized Offcial 316-640-0601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-10-22 |