| NPI | 1518180900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WES MARTIN GRAHAM Owner Administrator 620-249-2462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2025-09-11 |