| NPI | 1487840930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILE METCALFE Administrator 660-438-3488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2016-03-28 |