| NPI | 1952152829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE DUVALL Director Of Services 785-249-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-28 |