| NPI | 1033376603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L MAYO Administrator 641-484-3561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IA R419) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |