| NPI | 1912360074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY JOSEPH NICHOLS Chief Executive Officer 620-778-5802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 178011529) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |