| NPI | 1235401340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARI ASPER Owner 319-621-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: SC 29858) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: SC 29858) |
| Enumeration Date | 2012-02-04 |
| Last Update Date | 2012-04-30 |