| NPI | 1093868804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA A SUCKOW Controller 641-456-2532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |