| NPI | 1154955649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH M HAGER Provider/Member 515-321-4663 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-02-24 |