| 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 |