| NPI | 1003979485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE MARIE PITLIK Executive Director 319-377-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |