| NPI | 1003907437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES OTT Administrator 563-547-2398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IA R-478) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |