| NPI | 1922553791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JOSEPH BERNHARDT-PURDY President 620-208-9049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS 4910) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 750) |
| 251S00000X Community/Behavioral Health (Licence: KS 4910) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |