| NPI | 1861528986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNTHIA V. PONDER Administrator 816-923-9621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 7171986) |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2008-08-29 |