| NPI | 1871833285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BRIAN SIMMONS Owner 316-409-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: KS 07570128) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2015-12-22 |