| NPI | 1801520812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND L MORAN Owner 620-515-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-09-26 |