| NPI | 1851761332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L LOCK-GOOCH Operator 620-626-5672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: KS B088002) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2015-09-28 |