| NPI | 1174737209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA F. SEIFERT Administrator 563-245-2640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IA 0747477) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |