| NPI | 1275118333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD RUVINS Partner 515-447-3582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2022-12-06 |