| NPI | 1063878577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANN MARIE JENISON Sole Member 515-218-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 00679) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-28 |