| NPI | 1679573554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY ALLEN REA Acting Superintendent 620-421-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: KS M050101) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2020-08-22 |