| NPI | 1043800550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENICCA LUKER Accounting And Billing Supervisor 319-833-1187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-01-20 |