| NPI | 1134261969 |
|---|---|
| Doing Business As | CHILDSERVE STONECREST HOME |
| Entity Type | Organization |
| Authorized Contact | RODNEY WILDRICK Director Of Accounting 515-727-1468 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IA 771148) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-07-10 |