| NPI | 1083719587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIN ANDREW LODICO Owner 563-355-1611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2009-06-22 |