| NPI | 1184745424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY WILSON Program Director 515-288-4742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |