| NPI | 1134648561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANTE PATERSON Controller 913-961-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |