| NPI | 1154951168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN A PICKEN President 515-508-0961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |