| NPI | 1720447212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM BALLARD Credentialing Specialist 816-508-3569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 001912014) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| 101Y00000X Counselor (Licence: MO 001912014) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 001912014) | |
| 101YP2500X Counselor, Professional (Licence: MO 001912014) | |
| 104100000X Social Worker (Licence: MO 001912014) | |
| 1041C0700X Social Worker, Clinical (Licence: MO 001912014) | |
| 106H00000X Marriage & Family Therapist (Licence: MO 001912014) | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-11-29 |