| NPI | 1376906487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN KEITH SHERWOOD Owner 316-866-2882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4118) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 003) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-18 |