| NPI | 1326680422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIAN ZIMA CFO 712-256-7888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |