| NPI | 1255724654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAHI BOSEDA Counselor 816-679-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MO No.6748) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-04-10 |