| NPI | 1508338724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON R LONG CFO 913-215-0344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 104100000X Social Worker |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |