| NPI | 1013404557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL HOOVER Program Coordinator 515-408-5917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |