| NPI | 1295867042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS SAWYER Credentialing Specialist 660-626-0404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 1199) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2013-09-25 |