| NPI | 1912142399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OZANNA OBASI Director 816-728-3924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: MO G213223032) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MO G213223032) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2008-12-12 |