| NPI | 1215004122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK W STANG Clinical Director 620-792-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |