| NPI | 1174877641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY EATON Excutive Director 712-252-4547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 007700) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |