| NPI | 1316029705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY R. KUCKELMAN CAO 515-993-4535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-07-21 |