| NPI | 1609135235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS SAWYER Credentialing Specialist 660-626-0404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 1199) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |