| NPI | 1508681271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKA CLARK Nurse Practitioner 816-977-5341 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |