| NPI | 1114150943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN AVENAIM President 913-486-0364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: KS 2065) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: KS 1047) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |