| NPI | 1255412995 |
|---|---|
| Doing Business As | INDIANOLA RESIDENTIAL |
| Entity Type | Organization |
| Authorized Contact | RUSSELL LEE HEMNESS Owner 515-250-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IA 910290) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |