| NPI | 1922130004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANN MOORE Executive Director 620-285-3462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |