| NPI | 1952590168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY L JOHNSON Operator 913-371-3995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: KS B105114) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |