| NPI | 1326428004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA MCDERMOTT Owner 620-446-0056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KS 3984) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: KS 3984) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-07-21 |