| NPI | 1639625577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL LECLUYSE Organizer 816-916-7281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2002001828) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |