| NPI | 1861823668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY CROOK Owner 620-803-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: KS 200641990a) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KS 200641990a) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |