| NPI | 1255222816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN RENEE GAUGER Clinical Social Worker 515-778-9658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-07-11 |
| Last Update Date | 2025-07-15 |