| NPI | 1184080541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA COLEMON Executive Assistant To Cmo 515-282-2423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 05104) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2016-01-14 |