NPI | 1356635759 |
---|---|
Entity Type | Organization |
Authorized Contact | ADAM FRANCIS VILMONT Director/Owner 563-349-1638 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 03801) |
Enumeration Date | 2011-06-02 |
Last Update Date | 2024-04-08 |