| NPI | 1467414771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA BENNETT Director Of Office Operations 620-365-8641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KS 025) |
| Additional Taxonomies | 208000000X Pediatrics |
| 208600000X Surgery | |
| 207Q00000X Family Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 208800000X Urology | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2025-09-17 |