NPI | 1114292661 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURIE J COOLEY Director 712-243-5091 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IA 1267) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2012-03-16 |
Last Update Date | 2023-04-05 |