| NPI | 1134314578 |
|---|---|
| Other Name | 123RD |
| Entity Type | Organization |
| Authorized Contact | CARY L WILLIAMS CEO 816-761-8614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2010-08-24 |