| NPI | 1245236942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH COWLEY President 563-326-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-0438-0002-A) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0438-0002-A) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2018-05-30 |