| NPI | 1316702475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY EVANS Director 515-318-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |