| NPI | 1982806790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERELDINE I FACESON Administrator 816-965-5965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO 320900000x) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2010-03-02 |