| NPI | 1013067800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS BAKER Executive Director 515-993-4721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 251S00000X (Licence: IA 0469783) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2009-10-01 |