| NPI | 1689842858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN LANCE Regional Director 660-229-0175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-26 |