| NPI | 1629259320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D GLOVER Clinical Director 316-264-8800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2007-11-21 |