| NPI | 1033414826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M PETERSON Coordinator 515-897-0472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-04-09 |