| NPI | 1134662505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN WAYNE GUYER Owner/Director 816-519-8767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2016-12-02 |