| NPI | 1992028278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY E. BLOOMQUIST Managing Member 316-305-2964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 7471) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS AAPS Certification) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2010-03-01 |