| NPI | 1477522134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI PENDERGAST President 620-227-8803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2020-08-22 |