Organization
ALCOHOL AND DRUG SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE DALEN M.S., NCAC I, LCAC (PRESIDENT)
(913) 722-3866
Entity
Organization
Contact information
Practice address
6005 MARTWAY ST, STE. 102, MISSION, KS 66202-3374
(913) 722-3866
(913) 722-3867
Mailing address
6005 MARTWAY, STE. 102, MISSION, KS 66202
(913) 722-3866
(913) 722-3867
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
01160092
KS
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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