NPI | 1154496321 |
---|---|
Entity Type | Organization |
Authorized Contact | TODD SEIFERT CEO 563-652-5252 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IA 4703516) |
Enumeration Date | 2006-11-22 |
Last Update Date | 2020-08-22 |