| NPI | 1407988686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 660-665-1962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: KS 07110153) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable (Licence: KS 197) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2022-07-29 |