| NPI | 1356406201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE RENKEN Outpatient Business Mgr 712-293-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |