| NPI | 1134329816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE HUTTON Administrator 660-882-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2021-11-02 |