| NPI | 1427757673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SPENCER CREITZ Sr VP 620-240-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-02-27 |