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