| NPI | 1659708519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND LAWRENCE MALOTTE Director 913-888-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KS 32090000x) |
| Enumeration Date | 2013-10-08 |
| Last Update Date | 2013-10-08 |