| NPI | 1003253766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA MERCEDES LOPEZ Clinical Director 515-802-2487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 00763) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-03 |