| NPI | 1356640007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETUNIA M MONCHUSIE Mental Health Professional 913-748-7831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 138) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-03-21 |