| NPI | 1154451813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE BRECHT Administrator 1563-922-2881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |