| NPI | 1174568398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY LYLE PHILBRICK Director 316-941-9948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 429) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |