| NPI | 1225083728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAE IRENE ELIZABETH KRUCKENBERG CEO 515-576-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-03-01 |