| NPI | 1215080635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY VAN PATTEN Adminstrator 319-668-1659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IA R-653) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: IA R-653) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IA R-653) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |