| NPI | 1831311646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE DALBERG Divisional Commander 816-756-1455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable (Licence: KS 078) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: KS 076) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |