| NPI | 1174228639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CHRISTOPHER Executive Assistant 563-327-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2024-01-16 |