| NPI | 1588843742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY M CREEK Owner 816-347-8184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |