| NPI | 1770009219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANTE PATERSON Controller 913-961-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2018-10-24 |