| NPI | 1922058510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SOUTHERN Executive Director 620-275-0644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KS State of Kansas 001) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-05-17 |