| NPI | 1104288083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SUE TAYLOR Treatment Program Director 816-361-5239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MO 19991337748) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |