| NPI | 1326317538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRABHAKAR PISIPATI Owner 563-219-0675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |