| NPI | 1871146068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETE MACHUTTA Member 316-641-7698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |