| NPI | 1174658637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC ANTHONY HINES Chief Executive Officer 563-263-3545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IA unknown) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2024-03-16 |