| NPI | 1144294133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON M BUTCHER Administrator, V.P. 712-546-7844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IA R489) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-07-21 |