| NPI | 1104022953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY K TUCKER Owner 319-752-0940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: IA 4129000011) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |