| NPI | 1407247133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN E WILSON Board President 660-265-5942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |