| NPI | 1477877223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M TIBBITTS Director 816-221-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2000174524) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2025-05-23 |