| NPI | 1306185632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK C DODD Director 641-420-6959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 00293) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-04-11 |