| NPI | 1215362496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOA JEANNE VAN HOUTEN-GREEDY Therapist 712-313-0067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 8921) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NE P-1154) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2013-09-06 |