| NPI | 1124162052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SCOTT JACKSON Executive Director 620-848-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |