| NPI | 1285405522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RAE JOHNSON Billing Director 785-320-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-07-12 |