| NPI | 1316070139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA LYNN GRACE Owner 816-587-9224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 17639733) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2008-07-15 |