| NPI | 1104862549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK W STANG Clin Dir 620-792-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KS 004-06302011) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2015-05-06 |