| NPI | 1225104920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY WHITSELL Chief Executive Officer 712-324-4873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IA 0894949) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-08-22 |