| NPI | 1114083474 |
|---|---|
| Doing Business As | TANAGER PLACE PMIC |
| Entity Type | Organization |
| Authorized Contact | JEFF HUMISTON C.F.O. 319-365-9164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: IA 57PM-0005) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |