| NPI | 1477328110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANTE PATERSON CFO 913-333-1009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2023-11-22 |
| Last Update Date | 2023-11-22 |