| NPI | 1780140988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOLOLA BETHEL Owner 316-214-6104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 347C00000X Private Vehicle | |
| 251J00000X Nursing Care | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-13 |