| NPI | 1790030476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAX COLE Owner 316-683-0562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: KS B087171) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |