| NPI | 1720208887 |
|---|---|
| Doing Business As | YOUTHVILLE |
| Entity Type | Organization |
| Authorized Contact | DANY RAY MONARES Provider Relations Manager 316-283-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: KS 566) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2020-08-22 |