| NPI | 1275598054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA DHUSE Manager Mental Health 563-468-2145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-03-20 |