| NPI | 1144523523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI CLOCK Exec Assistant 913-647-7726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: KS 06530803) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2019-09-18 |