| NPI | 1053635292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE J RENFROW Executive Director 515-255-9490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 04652) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |