| NPI | 1245781525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA WATKINS Member 816-468-8731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2006012627) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |