| NPI | 1356415152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS C VICIAN Administrator 712-852-2267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IA RC7 018) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |