| NPI | 1154800456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELYNE JEANETTE CUNNINGHAM-SULLIVAN President 515-221-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IA 006960) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-12-03 |